Most also don’t have any benefits such as sick or vacation
time. In addition, some states do not regulate the industry, so the employer
can mandate working conditions.

A handful of home care employees are unionized, but it’s
difficult to unionize when the workforce is scattered throughout people’s
homes.

And training? In some states none at all is required.

The result is that people living in a state of perpetual
hardship end up being the ones who take care of our loved ones. Consider these
stories culled from the report:

Jasmin Almodovar of Cleveland makes $9.50 per hour after
working 12 years as a home care worker. She works 60 hours per week to bring
home about $500. She and her 11-year-old son moved in with another woman and
her four children to make ends meet.

Sylvia Foon Sau Liang of Seattle provides home care to her
adult child with autism (she is a single mother whose husband died of leukemia).
She also cares for an 86-year-old woman with dementia. Liang explains that her
work is exhausting, albeit gratifying. But she struggles to reconcile making so
little money when her work is so important.

In an interview with Healthline, Liliana Cordero of Chicago
said that’s exactly how she feels. She loves her job and works an average of 52
hours per week. At $9.85 per hour, the mother of two has to work that much just
to pay the bills. But when she’s sick, she takes a hit. She doesn’t get sick
pay and as a person caring for older adults she won’t go to work sick.

Her friends all ask … why not go back to school and find
something that pays better?

I feel that the Lord chose me to be here, that I should just be grateful for this job. My clients wait for me. They rely on me.

Liliana Cordero, home healthcare worker

“I feel that the Lord chose me to be here, that I should
just be grateful for this job,” she said. “My clients wait for me. They rely on
me.”

More Than Half of Workers Qualify for Food Stamps

Of the nation’s more than 2 million home care aides, more
than half make below 200 percent of the federal poverty level, according to the
report.

That means many of them rely on food stamps to put food on
the table and Medicaid for health insurance.

This is all happening at a time when demand for such workers
has ramped up to historic levels. Every day, thousands of baby boomers retire.
As they get older, more and more of them will need such services.

This will come to an absolute crisis for us and we will have to rethink our long-term care plan and how we finance it.

Abby Marquand, Paraprofessional Healthcare Institute

Abby Marquand is director of policy research for
Paraprofessional Healthcare Institute, or PHI, co-publisher of the home care
report. Marquand said the United States is headed for disaster with its current
home care model.

“We are not a country that deals with things proactively,”
she told Healthline. “This will come to an absolute crisis for us and we will
have to rethink our long-term care plan and how we finance it.”

Many things are contributing to the problem. One is the fact
that home care workers are not covered by the federal Fair Labor Standards Act.

“Since the 1930s and then again in the 1970s, home care aides
were carved out with just basic minimum wage and overtime protections,”
Marquand said. “It will take political will to change that.”

Home care workers are calling for a $15 per hour wage as
well as the right to unionize. For the past two weeks, the workers
have been attending rallies in more than 20 cities across the United States
to make their demands public.

“But home care wages are primarily set through public
reimbursement systems, given that the vast majority of these services are
funded through Medicaid and Medicare programs,” said Jodi Sturgeon, president
of PHI, in a news release accompanying the report. “It will take increased
public investment to raise wages, but better wages are essential to creating a
stable, qualified workforce in the years ahead.”

“The type of compassion required to really excel at this
type of work is easily exploited,” Marquand added. “We’ve heard the heads of
big home care trade associations call them angels or saints. Those are the
kinds of words you try to use when you describe someone who is undervalued.”

A top-to-bottom overhaul of the system is needed, Marquand
stressed.

“Right now it’s pieced together and fragmented, and it’s
impacting the quality of care to the people who need it,” she said.

We’ve heard the heads of big home care trade associations call them angels or saints. Those are the kinds of words you try to use when you describe someone who is undervalued.

Abby Marquand, Paraprofessional Healthcare Institute

By 2022, an additional 1 million home care aides will be
needed in the United States to meet the demands of the aging population.
Already, shortages exist in rural areas.

Because of the low pay, finding good help is a challenge.
Turnover is rampant, with about half of the workforce leaving each year,
according to PHI.

Jane Massey supervises home care workers for a large nonprofit
organization in Moline, Ill. She said keeping good workers is a never-ending
problem.

“The problem is, you get a good employee who does a good
job, but they’re constantly looking for a better-paying job. And a lot use this
as a stepping stone to get a better job in healthcare as they get additional
licensing.”

Are Our Loved Ones Getting Quality Care?

So what kind of care does this translate into for our
elderly parents, either now or in the future?

Cordero knows all about the bad apples who exist. For some,
home care is just a job – a job that is easy to get given the low pay and high
demands.

“It makes me angry,” she told Healthline. “I’ve walked in
after other home care workers have left and felt like I’ve had to clean up a
mess.”

Before working in home care, Cordero had a job at Walgreens.
It was there that she began to see older adults who needed help with just about
everything.

“Where are their children and why isn’t anyone helping
them?” she asked herself.

When she learned about home care she figured it was the
perfect job for her. She said the work has really opened her eyes to what
caregivers do.

Not until I got this job did I realize how much my aunt sacrificed for the whole family caring for my grandmother.

Liliana Cordero, home healthcare worker

“Not until I got this job did I realize how much my aunt
sacrificed for the whole family caring for my grandmother,” Cordero said.

Some Americans have heard enough bad stories about the home
care industry being low paying and unregulated that they don’t trust such employees with their loved ones.
Even under ideal circumstances, many people would rather take care of their
parents themselves.

People who qualify for home care through Medicaid can select
anyone as their provider, even one of their children.

Alantris Muhammad of Chicago quit her career in insurance to
care for her mom. Otherwise, her mother would have needed to enter a nursing
home because she requires 24-hour care.

“I’ve raised five sons and I’m currently putting the fourth
through college,” Muhammad says in the report. “Workers like me face tough
decisions all the time – should we pay the tuition bill or fix the oven that
broke right before Thanksgiving? Can we put gas in the car to take our
consumers to medical appointments or do we need to save that money for
groceries?”

Some families eliminate the middleman and hire home care
workers outright, allowing them to make twice as much money in some instances.
But deciding to employ someone privately sometimes comes with its own set of
issues.

Pressure Will Continue to Mount from Families, Workers

If nothing else, the plight of home care workers is becoming
front and center as more Americans share their stories.

Most home care workers are women. Half of them are women of
color. Long considered a domestic duty, home care is still often looked upon as
“women’s work.”

“For a lot of people
home care workers are the most essential person in their life,” Marquand said.
“They are the person who enables them to get out of bed.”

For a lot of people home care workers are the most essential person in their life. They are the person who enables them to get out of bed.

Abby Marquand, Paraprofessional Healthcare Institute

Many people don’t realize what finding someone to care for
their aged or ill relatives entails until it’s a problem that lands in their
lap. Those who are unable to care for a loved one personally often feel
horrible about it. It doesn’t help matters when finding quality care proves
difficult.

“We will reach a tipping point where everyone is going to
need these services either for themselves or for a loved one,” Marquand said.
“There are a lot of people who have yet to be exposed to the long-term care
system.”

She said the aging of America and lack of home care workers
is going to exert pressure on the workforce.

“People don’t want to work for so little money,” she said.

Expect pressure from the families of these elderly people,
too.

“These [home care workers] are the workforce that enables
the rest of us to work by caring for our loved ones,” Marquand said, adding the
current model simply is not sustainable. “It’s very fragile, and it’s being
balanced on the backs of the nation’s lowest paid workers.”

“This will be absolutely the crisis that everyone is
threatening,” she added. “We’re not able to wrap our heads around it because we
don’t want to.”